Performance Quality Analyst II
Carebridge job in Houston, TX
Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
The Performance Quality Analyst II is responsible for driving service quality excellence by evaluating the quality of services and interactions provided by organizations within the enterprise. Included are processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries.
How you will make an impact:
* Assists higher level auditor/lead on field work as assigned and acts as auditor in charge on small and less complex audits.
* Participates in pre and post implementation audits of providers, claims processing and payment, benefit coding, member and provider inquiries, enrollment & billing transactions and the corrective action plan process.
* Demonstrates ability to audit multiple lines of business, multiple functions, and multiple systems.
* Analyzes and interprets data and makes recommendations for change based on judgment and experience, applies audit policy, and assesses risks to minimize our exposure and mitigate those risks.
* Works closely with the business to provide consultation and advice to management related to policy and procedure identified as out of date or incomplete and investigates, develops and recommends process improvements and solutions.
* Functions as a subject matter expert for discrepancy review, questions from team and business partners, and interpretation of guidelines and audit process.
* Acts as a mentor to peer auditors, providing training and managing work and projects as necessary.
Minimum Requirements:
Requires a BS/BA; a minimum of 3 years related experience in an enrollment and billing, claims and/or customer contact automated environment (preferably in healthcare or insurance sector), including a minimum of 1 year related experience in a quality audit capacity; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences:
* WGS Claims processing experience strongly preferred.
* Experience/knowledge with local claim processing.
* Understanding of individual member benefits and cost shares preferred.
* Understanding of small, large and national group benefits and cost shares preferred.
* Prefer contract language.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Auto-ApplyCust Care Rep I-Bilingual (US)
Carebridge job in Houston, TX
Customer Care Representative -Bilingual Location: Hybrid: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office: 5959 CORPORATE DR
STE 1300, HOUSTON, TX 77036
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
The Customer Care Representative is responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues.
This position will have on-site training Monday - Friday for the first 24 weeks,
* Training (16 weeks): 8:00 AM - 4:30 PM CST
* Posting training (8 weeks) Typically 10:30 AM - 7:00 PM PT (some flexibility possible)
You must have 100% attendance during the full training period. Start date: 11/3/2025.
The Customer Care Representative is responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues.
How you will make an impact:
The Customer Care Representative is responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues.
How you will make an impact:
* Responds to customer questions via telephone regarding insurance benefits, provider contracts, eligibility and claims.
* Analyzes problems and provides information/solutions.
* Operates a PC/image station to obtain and extract information; documents information, activities and changes in the database.
* Thoroughly documents inquiry outcomes for accurate tracking and analysis.
* Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
* Researches and analyzes data to address operational challenges and customer service issues. Provides external and internal customers with requested information.
* Under immediate supervision, receives and places follow-up telephone calls / e-mails to answer customer questions that are routine in nature.
* Uses computerized systems for tracking, information gathering and troubleshooting. Requires limited knowledge of company services, products, insurance benefits, provider contracts and claims. Seeks, understands and responds to the needs and expectations of internal and external customers.
Minimum Requirements
* Requires a HS diploma or equivalent
* Previous experience in an automated customer service environment; or any combination of education and experience which would provide an equivalent background.
* Must be able to pass a validated language test/assessment.
Preferred Requirements
* High volume inbound call center experience preferred.
* Automated Customer Service experience preferred.
* Multi-tasking and data entry experience preferred.
* Language skills in: Spanish, Russian, Bengali, Cantonese and / or Mandarin are preferred.
* Previous Medicare / Medicaid experience preferred.
* Long-term care experience preferred.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Auto-ApplyRegional Coordinator
Houston, TX job
Regional Coordinator
REPORTS TO: Senior Regional Director
SUPERVISION EXERCISED: None
Grade/Class: Grade C, Non-Exempt, Non-Union
ABOUT THE ORGANIZATION:
ADL is the leading anti-hate organization in the world. Founded in 1913, its timeless mission is “to stop the defamation of the Jewish people and to secure justice and fair treatment to all.” Today, ADL continues to fight all forms of antisemitism and bias, using innovation and partnerships to drive impact. A global leader in combating antisemitism, countering extremism and battling bigotry wherever and whenever it happens, ADL works to protect democracy and ensure a just and inclusive society for all.
PRIMARY FUNCTION:
To provide comprehensive administrative and project management support to ADL's Center for Antisemitism Research (CAR) (50%) and the Texas regional teams (50%).
Responsibilities
RESPONSIBILITIES:
Provide high-level centralized support to both CAR and Texas teams, including program and event coordination, database management, administrative processing, calendar and schedule management, and communications.
Coordinate the timely processing of check requests, contracts and other administrative requirements in collaboration with various team members.
Support stakeholder communications and outreach efforts.
Coordinate and provide project management support for in-person events and ongoing project phases.
Schedule and support ongoing meetings for individuals and groups.
Track and order office supplies, process invoices and serve as primary interface with vendors.
Serves as a primary liaison between ADL's Texas regions and CSC (central office) on matters of technology and administrative systems. Be a champion for all new and existing technology, processes, workflows and tools/resources.
This provides a general overview of the role and its key responsibilities. It is not an exhaustive list of all duties, and ADL reserves the right to assign additional tasks as needed.
Qualifications
Skills:
Strong computer skills (including Word, Excel, and PowerPoint), analytical and interpersonal skills. Familiarity with project management tools a plus (MS Project, JIRA, etc..)
Demonstrated ability to prioritize and multi-task to complete projects on deadline.
Exceptional attention to detail.
Strong customer service and communication skills.
Strong team player.
Work Experience:
The ideal candidate has several years professional experience, including providing administrative support in a fast-paced office environment (On-campus student worker positions will be considered).
Education:
Bachelor's degree or equivalent experience .
Course work in Communications, Business Administration, or related fields is preferred.
Work Environment:
ADL is a hybrid environment; this role may require 3 days in the office.
Compensation:
This position has a salary range of $45,000 to $60,000. This salary range is reflective of a position based in Houston, TX. Please note that actual salaries are commensurate with experience and reflect the budget for a given position, and since ADL has a location-based compensation structure, there may be a different range for candidates in other locations. For an overview of our total rewards package, please visit **********************************
ADL aims to create a working environment where every employee can thrive professionally. Our mission-driven work is best accomplished in an environment that supports belonging. ADL values a diverse workplace and strongly encourages people of all races, religions, nationalities, genders, LGBTQ+ individuals, people with disabilities, and veterans to apply.
ADL is an equal opportunity employer. Recruitment, hiring, promotions and other terms, conditions and privileges of employment shall be maintained in a manner which does not discriminate on the basis of age, race, creed, religion, color, national origin, sex, sexual orientation, gender expression, marital status, physical or mental disability, veteran status, or military status, or in violation of any applicable Federal, state or local laws.
ADL will ensure that individuals with disabilities are provided reasonable accommodations to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. For individuals with disabilities who would like to request an accommodation to support the interview process, please contact the People & Culture department at
*************************
.
ADL will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the Fair Credit Reporting Act, and all other applicable State, Local, and Federal laws.
The information in this job description indicates the general nature and level of work expected of employees in this classification. It is not designed to contain, or be interpreted as, a comprehensive inventory of all duties, responsibilities, qualifications and objectives required of employees assigned to this job, nor is it to be interpreted as a contract for employment.
Auto-ApplyQuality of Life Program Manager- Hemophilia- Paragon Healthcare
Carebridge job in Houston, TX
Be Part of an Extraordinary Team A proud member of the Elevance Health family of companies, Paragon Healthcare brings over 20 years in providing life-saving and life-giving infusible and injectable drug therapies through our specialty pharmacies, our infusion centers, and the home setting.
Title: Quality of Life Program Manager- Paragon
Ideal candidates will be comfortable traveling 60-70% of the time to local Hemophilia chapters across the U.S.
The ability to attend Programs scheduled on nights and weekends will be required.
Field: This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
Build the Possibilities. Make an Extraordinary Impact.
The Quality of Life Program Manager- Paragon is responsible for developing and implementing innovative ""Quality of Life"" (QOL) programs for individuals with bleeding disorders to drive health outcomes and improve therapy adherence.
How you will make an impact:
Primary duties may include, but are not limited to:
* Collaborate with territory representatives to leading the increased business generation and customer retention.
* Develops and maintain business relationships with local chapters, clinics, and healthcare providers to enhance the business unit presence and impact in respective territories.
* Utilize lifestyle tools and resources within the QOL program to empower patients in managing their health, thus fostering a sense of control over their condition.
* Strategically integrate QOL initiatives into sales efforts to shorten the sales cycle and promote seamless health management solutions for patients.
* Leverage the QOL program as a significant referral source, contributing to business growth while maintaining cost-effectiveness compared to traditional event sponsorships.
* Monitor and evaluate the effectiveness of QOL programs regularly, making data-driven adjustments to ensure optimal patient engagement and satisfaction.
* Collaborate with cross-functional teams to align QOL initiatives with overall company objectives and marketing strategies.
Minimum Requirements:
* Requires a BA/BS degree and a minimum of 10 years of related experience in Specialty Pharmacy; and experience in marketing software (Aperture and Photoshop); or any combination of education and experience which would provide an equivalent background.
* Joint Health, Health and Nutrition and CPR certification are required.
Preferred Skills, Capabilities and Experiences:
* Prior experience as a professional Public Speaker is strongly preferred.
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $71,544 to $112,194
Locations: Colorado, Washington State
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Auto-ApplyReferral Services Assistant
Carebridge job in Houston, TX
Location: Virtual: This role enables associates to work virtually full-time (Indiana, Illinois, California, Texas, or Tennessee) , with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
Please note that per our policy on hybrid/virtual/ work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law
Work Schedule : An 8 hour shift based on the needs of the business. The hours of operation are Monday - Friday, between 7 am - 8 pm CST. Hours of operation on Saturday and Sunday are 8 am - 12pm CST.
The Referral Services Assistant is responsible for providing support to clinical team to facilitate the administrative components of clinical referrals for case management or disease management services to include home health, nutritional counseling, etc.
How you will make an impact :
* Initiates and manages clinical referrals for participants registered in a disease management or health program.
* Acts as a liaison between hospital, health plans, physicians, patients, vendors and other referral sources.
* Reviews referrals for completeness and follows up for additional information.
* Assigns referrals to staff.
* Verifies insurance coverage and obtains authorizations from insurance plans.
* Maintains database of insurance companies for verification of coverage, accepted plans, and requirements for patient eligibility.
* Contacts physician offices to obtain demographic information or related data.
* Enters referrals and documents communications in system.
Minimum Requirements :
* Requires a HS diploma and a minimum of 1 year of experience in a healthcare environment; or any combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences :
* Computer proficiency and the ability to navigate Microsoft Office products, especially Excel preferred.
* Strong communication and multi-tasking skills preferred
* Call center experience preferred.
* Health insurance or medical office experience preferred.
* Schedule flexibility with the availability for overtime preferred.
For candidates working in person or virtually in the below locations, the salary* range for this specific position is $16.01 to $30.32/hr.
Location: California and Illinois
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Auto-ApplyNurse Reviewer I
Carebridge job in Houston, TX
Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
Work Schedule: Monday through Friday, 9:30 AM - 6:00 PM CST or PST (Local Time)
A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is a benefit-management leader in Illinois. Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology and oncology.
The Nurse Reviewer I is responsible for conducting preauthorization, out of network and appropriateness of treatment reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines.
* Collaborates with healthcare providers, and members to promote the most appropriate, highest quality and effective use of diagnostic imaging to ensure quality member outcomes, and to optimize member benefits.
* Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management.
* Partners with more senior colleagues to complete non-routine reviews.
* Through work experience and mentoring learns to conduct medical necessity clinical screenings of preauthorization requests to assess the medical necessity of diagnostic imaging procedures, out of network services, and appropriateness of treatment.
How you will make an impact:
* Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
* Conducts initial medical necessity review of exception preauthorization requests for services requested outside of the client health plan network.
* Notifies ordering physician or rendering service provider office of the preauthorization determination decision.
* Follows-up to obtain additional clinical information.
* Ensure proper documentation, provider communication, and telephone service per department standards and performance metrics.
Minimum Requirements:
* Requires AS in nursing and minimum of 3 years of clinical nursing experience in an ambulatory or hospital setting or minimum of 1 year of prior utilization management, medical management and/or quality management, and/or call center experience; or any combination of education and experience, which would provide an equivalent background.
* A current unrestricted RN license in applicable state(s) required.
Preferred Experience, Skills, and Capabilities:
* Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed health care including HMO, PPO and POS plans strongly preferred.
* BA/BS degree preferred.
* Previous utilization and/or quality management and/or call center experience preferred.
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $33.12 to $ 54.41.
Locations: California; Illinois; Nevada
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Auto-ApplyHR Employee Relations Consultant Sr. - Bilingual Preferred
Carebridge job in Houston, TX
HR Employee Relations Consultant Sr. (Bilingual English/Spanish) Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
The HR Employee Relations Consultant Sr. (Bilingual English/Spanish) will be responsible for serving as the primary point of contact for associates and management for associate relations issues including but not limited to: investigations, agency charges (EEO, DOL), employment litigation, associate complaints, performance management, coaching, development, attendance, and other issues.
How you will make an impact:
* Provides advice, guidance, coaching, and training to associates and managers based on policies and legal consultation, and in accordance with employment laws and regulations.
* Conducts investigations including managing the witness lists, determining line of questioning, analyzing credibility, researching related records as needed and maintaining written record of the investigation.
* Debriefs leaders at all levels and HRBPs on findings.
* Provides oversight of the company's internal investigations of associate complaints and serves as a liaison to Legal on associate relations matters.
* Regularly partners with Ethics and Compliance on crossover investigations.
* Partners with AR leadership and HRBP for requests for transition agreements related to the separation/termination process, and will regularly use persuasive and advanced communication skills to communicate will all levels of associates throughout the organization.
* Develops and provides periodic associate relations-related analytical data and analyzes trends to determine appropriate action plans.
Minimum Requirements:
Requires a BA/BS degree and minimum of 5 years of human resources experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
* Bilingual English/Spanish strongly preferred.
* HR designation strongly preferred (SHRM-CP or SHRM-SCP ).
* Prior experience with Associate Relations and investigations strongly preferred.
* Workday or similar HCM experience preferred.
* ServiceNow experience preferred.
* Fortune/large company experience preferred.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Auto-ApplyGroup Underwriter, Senior
Carebridge job in Houston, TX
Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.
The Group Underwriter, Sr is responsible for determining acceptability of insurance risks and appropriate premium rates for small, complex renewal and prospect employer groups in accordance with Corporate Underwriting Guidelines and Authority Limits.
How You Will Make an Impact
Primary duties may include, but are not limited to:
* Determines and provides guidance to medical underwriters concerning the risk selection of applicants applying for commercial health coverage.
* Coordinates with other departments to ensure accuracy and consistency of overall account reporting.
* Proposes rates for prospective business utilizing a combination of other carrier experience, demographic data and manual rates.
* Performs post-sale reviews.
* Works with product and sales partners to survey existing product portfolios by market, monitors sales results, trends and needs, recommends product portfolio changes.
Minimum Requirements:
Requires a BA/BS in a related field; Minimum 4 years of related experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences:
* CPCU, CLU, LOMA, HIAA, PAHM or other insurance related courses preferred
* Level Funded medical underwriting experience strongly preferred.
* Small group experience preferred.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Auto-ApplyJean & Jerry Moore Policy Counsel
Houston, TX job
Policy Counsel REPORTS TO: VP, Policy Counsel SUPERVISION EXERCISED: None GRADE/CLASS: Grade H, Exempt, PSA-eligible
ABOUT THE ORGANIZATION
ADL is the leading anti-hate organization in the world. Founded in 1913, its timeless mission is “to stop the defamation of the Jewish people and to secure justice and fair treatment to all.” Today, ADL continues to fight all forms of antisemitism and bias, using innovation and partnerships to drive impact. A global leader in combating antisemitism, countering extremism, and battling bigotry wherever and whenever it happens, ADL works to ensure a just and inclusive society for all.
PRIMARY FUNCTIONS
The Jean & Jerry Moore Policy Counsel will play a central role in shaping and implementing ADL's local, state and national legislative and policy agenda using evidence-based legal approaches and tactics. As a legal, legislative, and policy subject matter expert on ADL's national advocacy priorities, the Policy Counsel will work in close coordination with external experts and ADL's national and regional teams to ensure that the policy and advocacy approaches ADL supports are legally sound, effective, and impactful.
Responsibilities
Primary:
Lead the development and implementation of legal and policy strategies in pursuit of ADL policy priorities, consistent with ADL research;
Monitor and analyze federal and state legislative, regulatory, and judicial developments that affect the safety of the Jewish community;
Partner with ADL's national and regional teams, including COE, CAR, the federal affairs team, the state and local advocacy team, regional offices, the litigation team, and other experts to provide real-time policy responses to incidents and trends;
Draft legislation, regulations, memoranda, position papers, public comments, and advocacy materials;
Collaborate with national security, law enforcement, and civil society partners to shape effective, constitutionally informed responses to threats;
Serve as a spokesperson or expert representative in public fora, during legislative briefings, and through media engagements as appropriate;
The Policy Counsel will also support shaping ADL's policy agenda in Texas.
This provides a general overview of the role and its key responsibilities. It is not an exhaustive list of all duties, and ADL reserves the right to assign additional tasks as needed.
Qualifications
Skills:
Exceptional legal research, analysis, and writing skills;
Strong public speaking and coalition-building capabilities.
Attributes:
Passionate about ADL's mission and driven to combat antisemitism in all forms.;
Open-minded and solutions-oriented with the ability to understand diverse perspectives;
Strategic thinker and effective advocate who can build consensus and advance complex policy goals;
Entrepreneurial mindset with the ability to lead initiatives and respond to emerging challenges;
Collaborative, strategic, and responsive under pressure.
Work Experience:
Demonstrated experience in policy, litigation, or advocacy roles.
Government, nonprofit, or legislative experience preferred but not required.
Experience with online harm, content moderation, and/or technology regulation is highly desirable.
Education:
J.D. degree required.
Work Environment:
Flexibility to work extended hours and travel occasionally as required.
Must be able to engage in prolonged computer and desk work.
Willingness to travel to regional offices, national convenings, or public events, including some weekends.
ADL is a hybrid environment; this role may require 3 days in the office.
Compensation:
This position has a salary range of $90,000 to $125,000. This salary range is reflective of a position based in Dallas, Texas. Please note that actual salaries are commensurate with experience and reflect the budget for a given position, and since ADL has a location-based compensation structure, there may be a different range for candidates in other locations. For an overview of our total rewards package, please visit **********************************
ADL aims to create a working environment where every employee can thrive professionally. Our mission-driven work is best accomplished in an environment that supports belonging. ADL values a diverse workplace and strongly encourages people of all races, religions, nationalities, genders, LGBTQ+ individuals, people with disabilities, and veterans to apply.
ADL is an equal opportunity employer. Recruitment, hiring, promotions and other terms, conditions and privileges of employment shall be maintained in a manner which does not discriminate on the basis of age, race, creed, religion, color, national origin, sex, sexual orientation, gender expression, marital status, physical or mental disability, veteran status, or military status, or in violation of any applicable Federal, state or local laws.
ADL will ensure that individuals with disabilities are provided reasonable accommodations to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. For individuals with disabilities who would like to request an accommodation to support the interview process, please contact the People & Culture department at
*************************
.
ADL will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the Fair Credit Reporting Act, and all other applicable State, Local, and Federal laws.
The information in this job description indicates the general nature and level of work expected of employees in this classification. It is not designed to contain, or be interpreted as, a comprehensive inventory of all duties, responsibilities, qualifications and objectives required of employees assigned to this job, nor is it to be interpreted as a contract for employment.
Auto-ApplyReferral Specialist II - Paragon Healthcare
Carebridge job in Houston, TX
A proud member of the Elevance Health family of companies, Paragon Healthcare brings over 20 years in providing life-saving and life-giving infusible and injectable drug therapies through our specialty pharmacies, our infusion centers, and the home setting.
Referral Specialist II - Paragon Healthcare
Schedule: Monday - Friday; 9:00am - 6:00pm Central
Hybrid 1: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
The Referral Specialist II is responsible for providing support to a clinical team in order to facilitate the administrative components of clinical referrals.
How you will make an impact:
* Acts as a first level SME, ability beyond intake calls that include working on production oriented work, may include physician assisting and/or special projects.
* Acts as liaison between hospital, health plans, physicians, patients, vendors and other referral sources.
* Reviews complex referrals for completeness and follows up for additional information if necessary.
* Assigns referrals to staff as appropriate.
* Verifies insurance coverage and obtains authorizations if needed from insurance plans.
* Contacts physician offices as needed to obtain demographic information or related data.
* Enters referrals, documents communications and actions in system.
* Associates in this role are expected to have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers.
* Additional expectations to include but not limited to: Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment; strong verbal and written communication skills, both with virtual and in-person interactions; attentive to details, critical thinker, and a problem-solver; demonstrates empathy and persistence to resolve caller issues completely; comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts.
* Associates in this role will have a structured work schedule with occasional overtime or flexibility based on business needs, including the ability to work from the office as necessary.
* Performs other duties as assigned.
Minimum Requirements:
* Requires HS diploma or GED and a minimum of 1 year of experience in a high-volume, interactive customer service or call center in a healthcare environment; or any combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
* Knowledge of medical terminology, plan specific guidelines; ICD-9 and CPT coding preferred.
* Benefit verification and authorization HIGHLY preferred.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Auto-ApplyMedical Director-Dermatology Appeals
Carebridge job in Houston, TX
Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
The Medical Director-Dermatology Appeals is responsible for the review of appeals for physical health medical services, to ensure the appropriate and most cost-effective medical care is received. May be responsible for developing and implementing programs to improve quality, cost, and outcomes. May provide clinical consultation and serve as clinical/strategic advisor to enhance clinical operations. May identify cost of care opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for an entire clinical program.
How you will make an impact:
* Complete appeal reviews in your specialty daily to ensure timely and consistent responses to members and providers.
* Provide guidance for clinical operational aspects of a program.
* May conduct peer-to-peer clinical reviews with attending physicians or other providers to discuss review determinations
* Serve as a resource and consultant to other areas of the company.
* May be required to represent the company to external entities and/or serve on internal and/or external committees.
* May chair company committees.
* Interpret medical policies and clinical guidelines.
* May lead, develop, direct, and implement clinical and non-clinical activities that impact health care quality cost and outcomes.
* Identify and develop opportunities for innovation to increase effectiveness and quality.
* Work independently with oversight from immediate manager.
* May be responsible for an entire clinical program and/or independently perform clinical reviews.
Minimum Qualifications
* Requires MD or DO and Board certification approved by one of the following certifying boards is required, where applicable to duties being performed: American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA).
* Board certification in Dermatology.
* Must possess an active unrestricted medical license to practice medicine or a health profession. Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US.
* Minimum of 10 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
* For Health Solutions and Carelon organizations (including behavioral health) only, minimum of 5 years of experience providing health care is required.
* Additional experience may be required by State contracts or regulations if the Medical Director is filling a role required by a State agency.
* For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a sensitive position work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties, principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Auto-ApplyAudit & Reimbursement III (US)
Carebridge job in Houston, TX
Audit & Reimbursement III Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. * Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs.
The Audit and Reimbursement III will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services). Under guided supervision, the Audit and Reimbursement III will gain experience on complex issues involving the Medicare cost report and Medicare Part A reimbursement. They will participate in contractual Audit and Reimbursement workload, and have opportunities to participate on special projects. This position provides a valuable opportunity to gain further experience in auditing and financial analysis within a growing healthcare industry. This position allows for educational opportunities leading to certifications and promotes a well-balanced lifestyle that includes professional networking opportunities.
How you will make an impact:
* Analyzes and interprets data and makes recommendations for change based on judgment and experience.
* Able to work independently on assignments and under minimal guidance from the manager.
* Prepare detailed work papers and present findings in accordance with Government Auditing Standards (GAS) and CMS requirements.
* Gain experience with applicable Federal Laws, regulations, policies and audit procedures.
* Respond timely and accurately to customer inquiries.
* Ability to multi-task while independently and effectively prioritizing work using time management, initiative, project management and problem-solving skills.
* Must be able to perform all duties of lower-level positions as directed by management.
* Participates in special projects and review of work done by auditors as assigned.
* Assist in mentoring less experienced associates as assigned.
Job specific functions for Reopening Team:
* Review Medicare cost report re-openings initiated from provider requests, CMS requests, or by the MAC
* Perform level 1 or level 2 audit review as part of the reopening process on all areas of the Medicare cost report such as Medicare DSH, Bad Debts, IME/DGME, NAH, Organ Acquisition and all cost based principles
* Analyze and interpret data per a provider's trial balance, financial statements, financial documents or other related healthcare records
* Actively participate in development of Audit & Reimbursement standard operating procedures
* Activity participate in workgroup initiatives to enhance quality, efficiency and training
Minimum Requirements:
* Requires a BA/BS degree and a minimum of 5 years of audit/reimbursement or related Medicare experience; or any combination of education and experience, which would provide an equivalent background.
* This position is part of our NGS (National Government Services) division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of living in the United States at least three of the past five years.
Preferred Skills, Capabilities and Experiences:
* Degree in Accounting or Finance preferred.
* Knowledge of CMS program regulations and cost report format preferred.
* Knowledge of CMS computer systems and Microsoft Office Word and Excel strongly preferred.
* MBA, CPA or CIA preferred.
* Must obtain Continuing Education Training requirements (where required).
* A valid driver's license and the ability to travel may be required.
If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed.
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $61,560 to $102,060
Locations: Maryland, Minnesota, Nevada, and New York
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Auto-ApplyTherapy Services Specialist (Bilingual Korean Required)
Carebridge job in Houston, TX
Sign-On Bonus: $3,000 The Therapy Services Specialist (Bilingual Korean Required) is responsible for working under the guidance of occupational therapist, collaborate with the managed care organization to support persons aging in place receiving home or community-based services.
Location: Virtual - This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.
How you will make an impact:
* Performs telephonic and/or virtual assessments to identify participants needs.
* Provides recommendations to MCO for type and hours of supportive services required.
* Conduct objective assessments for program participation to determine the appropriate level of support and services required.
* Obtain participant history to inform the comprehensive assessment.
* Complete assessments annually or more frequently as needed in accordance with applicable program requirements and participants needs.
* Educate program participants and MCO representative on options for home modifications, DME, assistive technology, or other adaptive equipment.
* Assists clinical team with the recommendations for equipment and services as needed. Collaborate with the support team to report observations and outcomes.
* Document all member encounters per documentation standards.
Minimum Requirements:
* Requires graduate of a college level program in physical therapy, occupational therapy, or an accredited two-year program for a Physical Therapist Assistant or Occupational Therapist Assistant and minimum of 2 years' experience in social service or health care field; or any combination of education and experience, which would provide an equivalent background.
* Current active, valid and unrestricted license or certification as a physical therapist assistant or occupational therapist assistant in applicable state required. Certification and/or licensure appropriate to field of specialty as required.
* Bilingual Korean Required.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Auto-ApplyProvider Relationship Account Manager
Carebridge job in Houston, TX
JR166584 Provider Relationship Account Manager Responsible for providing quality, accessible and comprehensive service to the company's provider community. Location: Hybrid 1: This role requires associates to be in-office 1 day per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
How will you make an impact:
* Develops and maintains positive provider relationships with the provider community by regular on-site and/or virtual/digital visits, communicating administrative and programmatic changes, and facilitating education and the resolution of provider issues.
* Serves as a knowledge and resource expert regarding provider issues impacting provider satisfaction and network retention; researches, analyzes, and coordinates prompt resolution to complex provider issues and appeals through direct contact with providers and internal matrixed partners.
* Collaborates within a cohort of internal matrix partners to triage issues and submit work requests.
* Generally, it is assigned to a portfolio of providers within a defined cohort.
* Coordinates Joint Operation Committees (JOC) of provider groups, driving the meetings in the discussion of issues and changes.
* May assist Annual Provider Satisfaction Surveys, required corrective action plan implementation and monitoring education, contract questions and non-routine claim issues.
* Coordinates communications process on such issues as administrative and medical policy, reimbursement, and provider utilization patterns.
* Conducts proactive outreach to support the understanding of managed care policies and procedures, as well as on a variety of initiatives and programs. Participates in external Provider Townhalls/Seminars and attends State Association conferences (e.g.: MGMA, AFP, AAP, HFMA).
* Identifies and reports on provider utilization patterns which have a direct impact on the quality-of-service delivery.
* Research issues that may impact future provider contract negotiations or jeopardize network retention.
Minimum requirements:
* Requires a bachelor's degree; minimum of 3 years of customer service experience including 2 years of experience in a healthcare or provider environment; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
* Ability to travel to worksites and other locations as needed.
* Candidates should reside within a commutable distance to one of our Pulse locations in Texas, specifically the Grand Prairie or Houston offices.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Auto-ApplyBehavioral Health EAP Consultant II
Carebridge job in Houston, TX
Shift: Sunday - Wednesday 6:00pm - 4:30am EST Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law
The Behavioral Health EAP Consultant II is responsible for providing 24/7 Behavioral Health and Employee Assistance services to up to approximately 10 million lives.
How you will make an impact:
* Supports Employee Assistance Program (EAP) service department by responding to initial customer contacts and request for services; receives client request, assesses situation, determines appropriate course of action.
* Provides telephone and/or on-site support for crisis intervention, assessment, short term problem resolution and referral to appropriate provider(s).
* Manages Critical Incident Stress Debriefing requests.
* Assesses members and assists them in accessing behavioral healthcare benefits available under their health plan.
* Applies specialized knowledge in substance abuse, domestic abuse, grief counseling, workplace problems, and management consultation.
* Provides employer consultation to supervisors, managers, and Human Resources of the EAP contracted organization.
* Manages shared mailbox that is used by clients and external vendor to forward information that must be reviewed and placed in documentation system.
Minimum Requirements:
* Requires a HS diploma or equivalent and a minimum of 5 years of direct psychiatric and/or substance abuse experience and prior managed care experience; or any combination of education and experience, which would provide an equivalent background.
* Current unrestricted license such as (but not limited to) LPC (as allowed by applicable state laws), LCSW, LMSW, LMFT, LMHC, or Licensed Professional Counselor, in applicable state(s) required.
Preferred skills, capabilities, and experiences:
* MA/MS preferred.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Auto-ApplyManager II Grievance & Appeals
Carebridge job in Houston, TX
Manager II Grievance/Appeals - Claims Support Office Locations: The selected candidate must reside within a reasonable commuting distance of the designated posting location(s): Indiana, Georgia, Ohio, Maryland, North Carolina, Tennessee, Texas, Virginia, Wisconsin, District of Columbia, Maryland, New Jersey and New York.
Hybrid 2: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
The Manager II Grievance & Appeals responsible for management oversight of grievances and appeals departmental units to investigate, resolve, and respond to grievances and appeals, manages inventory and production levels, and operational and plan risk, ensures quality, and regulatory compliance. This role specifically oversees the IRE Team.
How you will make an impact:
* Coordinates Grievance and Appeals Committee Meetings.
* Assists grievance and appeals leadership in regulated audits.
* Oversight of the IRE portions of Medicare audits and universe production.
* Serves as a resource for complex issues and interpretation of claims, provider contracts and data, eligibility, member contracts, benefits, clinical decisions, pharmacy on pre-service and post service appeals and grievances related to non-clinical and clinical services, quality of service and quality of care issues including executive and regulatory grievances.
* Oversees and implements new subsystems, procedures, techniques and supports digital automation objectives.
* Analyzes and develops strategies by achieving performance thresholds within budgetary guidelines.
* Monitors trends and analyzes grievance and appeals data to identify and recommend plan and policy changes and to ensure state and federal regulatory compliance and resolution within the regulatory timeframes.
* Ensures programs support overall QI program and meet regulatory compliance/accreditation and the company standards. Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Minimum qualifications:
* Bachelor's degree and a minimum of 5+ years grievance & appeals experience and a minimum of 3 years of management experience in the healthcare industry; or any combination of education and experience which would provide an equivalent background.
* For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
Preferred Skills, Capabilities and Experiences:
* Three years of managerial experience is strongly preferred
* Experience with IRE/Maximus and Medicare compliance, programs, guidelines, and processes are strongly preferred.
* Solid knowledge of Medicare Grievance and Appeals rules and regulations is highly preferred.
* Demonstrated critical thinking and problem-solving abilities are highly preferred.
For candidates working in person or virtually in the below locations, the salary* range for this specific position is $82,720 to $148,896
Locations: District of Columbia, Maryland, New Jersey and New York
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Auto-ApplyAudit & Reimbursement Senior
Carebridge job in Houston, TX
Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. * Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs.
The Audit and Reimbursement Senior will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare cost reports and Medicare Part A reimbursement. This position provides a valuable opportunity to gain advanced experience in auditing and financial analysis within a growing healthcare industry. This position allows for educational opportunities leading to certifications and promotes a well-balanced lifestyle that includes professional networking opportunities.
How you will make an impact:
* Evaluate the work performed by other associates to ensure accurate reimbursement to providers.
* Assist Audit and Reimbursement Leads and Managers in training, and development of other associates.
* Participates in special projects as assigned.
* Able to work independently on assignments and under minimal guidance from the manager.
* Prepare detailed work papers and present findings in accordance with Government Auditing Standards (GAS) and CMS requirements.
* Analyze and interpret data with recommendations based on judgment and experience.
* Must be able to perform all duties of lower-level positions as directed by management.
* Participate in development and maintenance of Audit & Reimbursement standard operating procedures.
* Participate in workgroup initiatives to enhance quality, efficiency, and training.
* Participate in all team meetings, staff meetings, and training sessions.
* Assist in mentoring less experienced associates as assigned.
* Prepare and perform supervisory review of cost report desk reviews and audits.
* Review of complex exception requests and CMS change requests.
* Perform supervisory review of workload involving complex areas of Medicare part A reimbursement such as Medicare DSH, Bad Debts, Medical Education, Nursing and Allied Health, Organ Acquisition, Wage Index and all cost based principles.
Minimum Qualifications:
* Requires a BA/BS and a minimum of 8 years of audit/reimbursement or related Medicare experience; or any combination of education and experience which would provide an equivalent background.
* This position is part of our NGS (National Government Services) division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of living in the United States at least three of the past five years.
Preferred Qualifications:
* Accounting degree preferred.
* Knowledge of CMS program regulations and cost report format preferred.
* Knowledge of CMS computer systems and Microsoft Office Word and Excel strongly preferred.
* Must obtain Continuing Education Training requirements.
* MBA, CPA, CIA or CFE preferred.
* Demonstrated leadership experience preferred.
* A valid driver's license and the ability to travel may be required.
If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed.
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $ 73,720 to $122,220
Locations: Maryland, Minnesota, Nevada and New York
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Auto-ApplyTelephonic Nurse Case Manager II
Carebridge job in Houston, TX
$3000 Sign-On Bonus Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
Hours: Monday - Friday 8:30 - 5 pm CST or MST.
* This position will service members in different states; therefore, Multi-State Licensure will be required.
The Telephonic Nurse Case Manager II is responsible for care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically.
How you will make an impact:
* Ensures member access to services appropriate to their health needs.
* Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
* Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
* Coordinates internal and external resources to meet identified needs.
* Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
* Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
* Negotiates rates of reimbursement, as applicable.
* Assists in problem solving with providers, claims or service issues.
* Assists with development of utilization/care management policies and procedures.
Minimum Requirements:
* Requires BA/BS in a health related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
* Current, unrestricted RN license in applicable state(s) required.
* Multi-state licensure is required if this individual is providing services in multiple states.
Preferred Capabilities, Skills and Experiences:
* Case Management experience is preferred.
* Certification as a Case Manager is preferred.
* Minimum 2 years' experience in acute care setting is preferred.
* Managed Care experience is preferred.
* Ability to talk and type at the same time is preferred.
* Demonstrate critical thinking skills when interacting with members is preferred.
* Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly is preferred.
* Ability to manage, review and respond to emails/instant messages in a timely fashion is preferred.
For candidates working in person or virtually in the below locations, the salary* range for this specific position is $80,608 to $120,912.
Locations: Colorado.
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Auto-ApplyGroup Underwriting Consultant Sr.
Carebridge job in Houston, TX
Group Underwriting Consultant Senior Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
The Group Underwriting Consultant Senior will be responsible for determining acceptability of insurance risks and appropriate premium rates for large and complex group cases. Position is the most senior technical underwriting expert.
How you will make an impact:
* Calculates renewal rates for large complex cases based on thorough analysis of experience, location, demographics, etc.
* Determines and provides guidance to medical underwriters concerning the risk selection of applicants applying for individual health coverage.
* Coordinates with other departments to ensure accuracy and consistency of overall account reporting.
* Proposes rates for prospective business utilizing a combination of other carrier experience, demographic data and manual rates.
* Performs post-sale reviews.
* Prepares or supervises preparation of annual settlements, ERISA reports, rate projections, or benefit change increments and decrements.
* Surveys existing product portfolios by market, monitors sales results, trends and needs, recommends product portfolio changes.
* Assists in establishing rating and administrative procedures.
* Participates in major multi-functional teams as an underwriting representative.
* Assists in the technical development of underwriting associates, which may include monitoring reports and workflow to provide recommendations on productivity and efficiency improvements.
* Updates and monitors departmental processes and procedures in compliance with system, regulatory and business requirements.
Minimum Requirements:
Requires a BA/BS in a related field; Minimum 7 years of related experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
* Medical insurance underwriting experience strongly preferred.
* Intermediate Microsoft Excel experience to include advanced proficiency in formulas, PivotTables, VLOOKUPs, and macros is strongly preferred.
* CPCU, CLU, LOMA, HIAA or other insurance related courses preferred.
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $95,600 to $164,910.
Locations: California, Colorado, Illinois, Washington State
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Auto-ApplyDirector II Medical Cost Intelligence AI & Engineering
Carebridge job in Houston, TX
Director II Medical Cost Intelligence AI & Engineering (Dir II Engineering) Location: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered if candidate resides within a commutable distance from an office.
The Director II Medical Cost Intelligence AI & Engineering is responsible for strategic oversight and delivery of enterprise technology solutions, inclusive of AI, analytics and agentic solutions, business units and enterprise functions focused on managing medical cost. Delivery responsibilities will include leading engineering teams and collaborating with internal technology teams to deliver scalable enterprise level solutions that will proactively manage medical costs through the use of AI & analytics focused capabilities to drive affordable healthcare across the industry. The role will also be responsible for drive innovation technology solutions that change the strategic landscape of how Elevance Health manages medical costs and proactively identifies and takes actions to ensure affordable healthcare.
How you will make an impact:
* Planning, directing, and controlling multiple teams of resources and initiatives to accomplish the objectives and requirements defined by senior technology and product management across multiple teams. This is inclusive of design, development, and testing teams delivering AI & analytics solutions.
* Provides technology thought leadership to business partners ensuring teams are delivering scalable solutions that enable enterprise level priorities and financial goals.
* Responsible for the planning and execution of technology solutions and the ability to manage to budgetary constraints.
* Interfaces with key technology solution vendors; develops strategies and facilitates performance measurement plans to optimize vendor and associate performance and outcomes.
* Develops application technology plans, forecasting for an enterprise application, enterprise-wide tool, infrastructure, or a center or domain that is equivalent in scope and complexity.
* Manages a domain or suite of applications (or the equivalent capital and/or level of responsibility).
* Oversees strategic planning, budget development, and management for a single large or multiple cost centers, contract compliance, and any necessary integration of government regulatory requirements.
* Ensures disaster recovery and business continuity plan are implemented, monitored, and updated on a recurring basis.
* Ensures delivery and supports system solutions that support the continuous operations.
* Identifies and resolves hurdles for assigned areas/groups according to established deadlines.
* Establishes and maintains collaborative relationships with key business partners.
* Partners with customers in order to understand new product enhancements or features being requested.
* Plans and executes annual projects while maintaining profit and loss (P&L) responsibility.
* Establishes and maintains collaborative relationships with key business partners.
* Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Minimum Requirements:
Requires an BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 8 years of IT management experience in the area of function being managed; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
* Health insurance industry experience, specifically at a provider or payer strongly preferred.
* AI delivery of business solutions strongly preferred.
* Experience delivering AI and technology solutions for a targeted business function strongly preferred.
* Prior people leadership experience preferred.
If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a `sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed. Please Note: If this is not a straight backfill, please consult with your HR Business Partner prior to posting/using this job.
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $199,936 to $327,168.
Locations: California, District of Columbia (Washington DC), Illinois, New York
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Auto-Apply